EVALUATION OF APNS’ CLINICS
THROUGH ANALYSIS OF THEIR
PATIENT RECORD DOCUMENTATION
Carola Wisur-Hokkanen
Supervisor team:
• Carola Wisur-Hokkanen Åbo Akademi University,
Faculty of Education and Welfare Studies, Vasa central
Hospital
• Regina Santamäki-Fisher, Åbo Akademi University,
Faculty of Education and Welfare Studies
• Raimo Isoaho University of Turku
• Ann-Louise Glasberg Novia University of Applied
Sciences
• Lisbeth Fagerström Faculty of Health and Social
Sciences, University College of Southeast Norway,
Norway, Åbo akademi University, Faculty of Education
and Welfare Studies
Background:
• Advanced practice Nursing (APN) is an
umbrella term encompassing different types
of advanced nursing roles, such as Nurse
Practitioner and Clinical nurse specialist.
• Evaluation of new APN roles from different
angels is recommended in literature.
The aim of the study:
• Aim: to explore the content of the Advanced
Practice Nurses’ (APN) clinical work in primary
health care in Western Finland and to assess
the quality of their care by evaluating their
patient record documentation.
Methods:
• This descriptive study was conducted at a primary healthcare center.
• The APNs had developed three different APN clinics:
– acute patients with minor health illnesses,
– chronic diseases
– home-dwelling palliative patients.
• Data was collected under a period of 1-3.2014 from eight APN clinics and
consisted of 87 patient records.
• The material was analyzed by two independent researchers, with the main
focus on the relevancy of the APNs’ patient documentation.
• The following parameters were reviewed:
– Patient history
– Status
– Intervention
– Health education and Guidance to self-care
• The parameters were graded separately on a
five graded Likert scale.
• Maximum points were 20 and minimum 1.
• If information was lacking, not mentioned or
documented under the wrong heading or
could not be evaluated it was classified as 0.
• After the researchers had evaluated
individually the material they compared the
reviews.
Findings:
• The preliminary results:
– APNs’ documentation at the clinic for acute patients was
most relevant.
Patient history
Staus
Intervention
Health education and
Guidence to self-care
Acute patients
Chronically ill patients Palliative patients
R1
R2
R1
R2
R1
R2
4,5
4,6
4,2
4,1
4,3
4,5
4,5
4,7
3,3
3,3
3,5
3,3
4,5
4,7
3,2
3,7
3,6
3,8
4
4,6
3,3
3,9
3,7
3,6
– The mean for patient history, status, and intervention was
between 4.5 and 4.7, and Health education and Guidance
to self-care between 4.0 and 4.6.
– APNs’ documentation at the other two clinics was
evaluated as slightly less relevant.
What was learned:
• Analyses of the content of the APNs’ clinical
work is on-going.
• Implementation of the APN role in primary
healthcare has started successfully, and this
study showed that the quality of the APNs’
documentation is at a good level.